Yavaibvisa nitroprusside: mirayiridzo kushandiswa

Kune mishonga yakawanda kuti vane hypotensive migumisiro. Zvinodhaka kuti kudukupiswa BP, unowanzoshandiswa nenzira kunzwisisa uye dzakawanda (1-2 nguva zuva). Saka zvakaipa neBP. Mune zvimwe zviitiko, setsika mishonga yokuderedza BP regai kushandisa. Zvadaro shandisa mishonga akasimba akadai mhinduro 'kuti yavaibvisa nitroprusside. " mushonga uyu hauna kushandiswa zvakanyatsorongwa uye pasina chakakomba chokunamata. Hachisi mishonga rwokusarudza kuti Mabatirwo neBP uye chirwere chemwoyo. Rinoshandiswa chete nyaya yokukurumidzira, kana muviri omunhu asingadi kupindura zvimwe zvinodhaka kuti kuderedza BP (diuretics, ACE FIs). A mhinduro 'kuti yavaibvisa nitroprusside "haagoni kupiwa oga, pasina mushonga.

Chaizvoizvo chii mushonga une pamusoro muviri?

Kugadzirira "Sodium nitroprusside" (payakavakirwa - C ₅ FeN ₆ Na ₂ O) rinoreva boka peripheral vasodilators. Rine nefuma yerima yakatsvuka muchimiro crystals kana upfu. Asi gadziriro dzayo rakasanganiswa nemvura uye kushandiswa mvura chimiro. Nokuda kuti pane boka nitroso, kushandisa zvinodhaka ndiko kunokonzera vasodilation ari Kuronga fuma. Izvi zvinoitika sezvinotevera: Izvi kwemakemikari remubatanidzwa kana anwa iri dzikwanise nitric oxide uye zvaanopa simba ari enzayemu - guanylate cyclase. Izvozvi kunowedzera inotungamirwa cGMP izvo zvinowanzoita kuti kuunganidza mu vascular kumeso tsandanyama uye anoita kuzvivaraidza kwayo. Nokudaro, medicament "Sodium nitroprusside" chinopa zvinotevera migumisiro uye arterio venodilatiruyuschy uye hypotensive. Kuburikidza nebasa iri vascular gadziriro iri kuwana nokukurumidza nani. Mukuwedzera, mushonga unoshanda maererano mhando cardiac glycosides, i.e. izvozvo kunoderedza myocardial okisijeni kudiwa. Izvi zvinoitwa chi- uye afterload kuderera.

zvairatidza medicament

Zvinofanira kunzwisiswa kuti mushonga unoshandiswa chete zvashata zviitiko zvirwere zvakakomba uye kurwisa kuti muviri kune mamwe mapoka medicaments. Zvairatidza kuti kushandiswa kwezvinodhaka anonzi:

1. Chenjera mwoyo kutadza. In Kunyanya tine mupfungwa kukura pulmonary edema (cardiac asima). The mushonga iri nokukurumidza kuita mamiriro ichi pasina mugumisiro diuretics.
2. Chirwere mwoyo kukundikana, yakanyanya. The wokupedzisira pavaipfuura chisingaperi mwoyo nokukundikana (2b, 3) havasi sei kurapwa. Naizvozvo, kana kuramba zvimwe zvinodhaka uye chokunyevera ezvinhu omurwere varayire peripheral vasodilators.
3. Chenjera coronary syndrome. Mune zvimwe zviitiko, mushonga inoshandiswa myocardial infarction, kuti kudzibatsira muropa nemidziyo mwoyo, uyewo kudzivisa chitange cardiogenic kuvhunduka.
4. Intractable nezvaiitwa kurapwa kuti BP. Vasodilators aitwe pheochromocytoma, paroxysmal nematambudziko, uyewo kugadzirwa kwepurogiramu kwazvo yematambudziko akakonzerwa unopinza kuwedzera BP (sitiroko, psychogenic zvirwere, chirwere chemwoyo).
5. Ergot chepfu. chirimwa Izvi yakapinza vasospasm, izvo zvinogona kutitadzisa Via medicament "yavaibvisa nitroprusside." Mirayiridzo zvokushandisa pasuru inoisa anofanira zvakanaka kunzwisiswa navanachiremba "amburenzi" uye nokumutswa.

Contraindications uye divi migumisiro

The mushonga harifaniri kushandiswa Hemorrhagic sitiroko, uyewo pashure pacho. Zvinonzi contraindicated vanhu vachitambura nekuora cheitsvo uye hypothyroidism. zviri haana pachii vanhu vane kwakawedzera intracranial kuvafurira. Kushandiswa mishonga chinorambidzwa vana, vakadzi vane pamuviri uye vanhu pakukwegura. Chimwe contraindication iri chinonyanyisa vanoshingaira mumiririri pamwe kukura neutachiona.

Pakati divi migumisiro kubva pakushandisa "yavaibvisa nitroprusside" gadziriro ndiko kupa rakapinza kuderera BP (iyi, zvakakosha kumisa pakarepo Kutarisirwa), wakawedzera zvazvingava mwoyo, dzungu, kuda kurutsa uye mukuru muutera.

Chemical maitiro pamwe yavaibvisa nitroprusside

Kuwedzera kupa mishonga mugumisiro yavaibvisa nitroprusside fuma zvaishandiswa nemakemikari. Kana kusanganiswa ketone muviri (acetone) uye ukaiswa muimba alkaline ezvinhu, unogona kuona kuchinja kunoshamisa noruvara mukomboni. For transformations vakadaro uchishandisa 4 sepombi. Mune mumwe aisa imwe chete fuma - yavaibvisa nitroprusside, acetone, alkali, acetic acid. Muchiitiko chokutanga kunoguma mhinduro akatendeuka wakajeka orenji-tsvuku Hue. Next, remubatanidzwa ichi rakasanganiswa acetic acid. Color zvakachinja zvakare, panguva ino nemvura anova rima tsvuku kana shava.

Kugadzirira "Sodium nitroprusside": mirayiridzo kushandiswa

Kupinda mushonga, zvinokosha kuwana intravenous kuwana. Pakarepo pamberi kutanga zvinodhaka aizomupa, kunofanira rakasanganiswa muna 5% shuga mhinduro. Nokuti chinangwa ichi, 1 chinu zvinodhaka ari sirinji uye rakasanganiswa 5 ml mvura. The zvichiguma musanganiswa yakanga jekiseni kupinda chinu pamwe 5% shuga kukurumidza zvakare. Pashure paizvozvo, kunhonga achida chipimo chemushonga. It yemakomo kubva 0.3 kusvika 8 g pa 1 kg kurema muviri. The aizomupa yakaitwa kubudikidza hurongwa. Inofanira kutanga pasi dose uye zvishoma nezvishoma kuwedzera pasi pesimba zviratidzo zvinokosha (BP, kwemwoyo, kufamba kweropa). Zvinokoshawo kuti muenzaniso zvinogamuchirika aizomupa zvazvingava yakaenzana 2.5-3 MG / makirogiramu muna 1 miniti. The chipimo chemushonga kunoenderana nenguva zvinodhaka kutarisira. Refu aizomupa anofanira kuongorora padanho cyanide tubhokisi medicament mu "Sodium nitroprusside". Mirayiridzo kushandiswa kwezvinodhaka kunofanira kuchengetwa zvakajeka.

Kudyidzana nevamwe zvinodhaka

Hatidi kuvakurudzira kushandisa zvinodhaka, uye dzimwe antihypertensive vamiririri, sezvo zvichiita kukura ane mamiriro nehana. Tapota ziva kuti kushandiswa nomumukanwa nhumbu akazoita kubudirira chezvinodhaka. Kana kunosanganisira medicament zvinodhaka "Dobutamine" zviratidzo murwere inokosha inofanira nokungwarira kuongororwa (zvichida akaderedza kumanikidzwa, wedging ari zvemapapu midziyo uyewo yakawedzera cardiac vhoriyamu).